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From the President: Emerging Issues

 A View from Washington: A Push is on to Study the Health Impact of Gun Violence

By Amy Haddad
Director of Policy and Government Affairs
AMCHP

I've been searching for a good definition to describe social justice in a health context that connects the concept to the issue of gun violence as a public health issue and came across Jennifer Prah Ruger's theory that all people should have access to the means to avoid premature death and preventable morbidity. It's so simple and clear (in language, if not in practice). When, according to a study published last year in  Pediatrics, firearm-related deaths are the third leading cause of death among children in the U.S. aged 1 to 17, there is no question that addressing gun violence as a public health issue is key to promoting social justice.

Following the tragedy at Sandy Hook Elementary School in Newtown, Connecticut in 2012, AMCHP adopted a position on taking a comprehensive public health approach to protect children and prevent gun violence, including support of certain policies. Five-and-a-half years later, we remain committed to this position and continue our advocacy for federally supported research on the causes and prevention of gun violence as well as to understand how and when firearms are used in violent death.

According to the U.S. Centers for Disease Control and Prevention (CDC), there were over 38,000 gun-related deaths in the United States in 2016. Sadly, we don't have to look very hard to read another story in the news about young people whose lives are taken too soon by gun violence. Each time an event results in multiple fatalities, the political discourse around guns intensifies, then wanes. But this year AMCHP and others in the public health community are seizing on what we see as a small window of opportunity to, at the very least, restore federal funding for gun violence prevention research.

For over 20 years, Congress has included as part of its annual appropriations bill a provision known as the Dickey Amendment, which says, "None of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention (CDC) may be used to advocate or promote gun control." For years, this provision has had the practical effect of preventing federally funded research into gun-related injury and death for fear of breaching the language of the amendment.

Earlier this year, however, Secretary of Health and Human Services Alex Azar appeared in public Congressional hearings, where he answered questions regarding the Dickey Amendment and stated, "My understanding is that the rider does not in any way impede our ability to conduct our research mission. … We're in the science business and the evidence-generating business, and so I will have our agency certainly working in this field, as they do across the broad spectrum of disease control and prevention." If the Dickey Amendment previously had a chilling effect on federally funded gun violence prevention research, I would call this step one in the warming process.

Step two came when the FY2018 Omnibus Appropriations Act contained language stating, "While appropriations language prohibits the CDC and other agencies from using appropriated funding to advocate or promote gun control, the Secretary of Health and Human Services has stated the CDC has the authority to conduct research on the causes of gun violence." Essentially, this language restated what Azar said, but further amplified that view in federal law.

Step three, however, is the one we are working on now and that can potentially put some meat on these bones: dedicated funding. Absent dedicated funding for the purpose of conducting research into gun violence prevention, our already cash-strapped federal research institutions will never invest in this area. In a best-case scenario, funding would have to be diverted from other worthy public health research investments – something we wouldn't want to see happen.

That is why AMCHP recently joined over 80 organization in the public health, medical, and research communities urging Congress to provide $50 million in dedicated funding for the CDC to conduct public health research into firearm morbidity and mortality prevention. We are proud to be partners in this effort, are working to see funding appropriated in fiscal year 2019 and look forward to step four: putting the results of this research into practice so that we can do our best to ensure that all people have access to the means to avoid premature death and preventable morbidity due to gun violence.